BENJAMIN SHEARD BER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

SHEARD

Last Name

BER

Business Name

BENJAMIN SHEARD BER

Original Issue Date

07/15/2002

Effective Date

07/15/2002

Expiration Date

09/30/2004

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005